Report Publish Date: December 29, 2023

This issue brief gives an overview of Medicaid, the public health insurance program for people with low incomes, as well as its built-in inequities and policies that could make it more equitable.  

Primary Takeaways

People who are not White and eligible for Medicaid have more difficulty gaining coverage compared to White people; and, once covered, they face more barriers to accessing quality healthcare.  Some policies that could make Medicaid more equitable include: Expanding Medicaid in all states. Expanding postpartum coverage to 12 months in all states. Improving federal oversight and creating payment models that help expand the number of providers who accept Medicaid. Better engaging Medicaid participants in helping to improve the program. 

Overview and Objectives

Medicaid is the largest U.S. insurer; it covered 25% of Americans in 2023. Yet while it is an important source of healthcare for low-income people in the United States, deep inequities persist that keep enrollees from getting quality, consistent care.  The authors wanted to provide a guide for advocates and policymakers to help them understand how Medicaid works and how it could be improved. 

Hypothesis or Approach 

The authors describe who is covered by Medicaid, who provides services to them, how the program is paid for, barriers to enrollment and to receiving quality health care services while enrolled, disparities between White and nonwhite Medicaid members, and how Medicaid is held accountable. They also list policies that could help more people access Medicaid and reduce disparities among those enrolled. 

How This Influences Change

This guide helps readers understand what aspects of Medicaid could be changed for the better and what policy levers might help us make those changes.